Document to Defend

Meticulous documentation will come in handy if a physician is called upon to prove the accuracy of his or her coding, according to Trevor Stone, AAFP's manager of private sector advocacy. Stone said in the past year some members have reported receiving letters from insurance companies warning them about inaccurate coding. The insurers claim the physicians are billing more of one code level -- usually a 99214 -- than other physicians in the insurer's panel of physicians.

Don't be afraid to challenge the payer, said Stone. Check out "Getting Paid: Are You Prepared to Defend Your Coding?" published in the June 2005 Family Practice Management, for coding tips, coding resources available through the AAFP and others, as well as a sample letter to use when responding to a health plan audit.